Self-harm is thought by many to be a modern epidemic: a phenomenon of the late twentieth century, a symptom of extreme emotional turmoil in young people, particularly young women. Yet it was 150 years ago, within early asylum psychiatry, that self-mutilation was first codified as a category of behaviour, and explanations for a variety of self-injurious acts were conceived very differently.

Psyche on the Skin charts the secret history of self-harm. The book describes its many forms, from sexual self-mutilation and hysterical malingering in the late Victorian period, to self-castrating religious sects, to self-mutilation and self-destruction in art, music and popular culture. Sarah Chaney’s refreshing historical approach refutes the notion that self-harm has any universal meaning – that it necessarily says something specific about an individual or group, or that it can ever be understood outside the historical and cultural context of a particular era.

Drawing on her personal experiences, written in an engaging style and containing many powerful images, Psyche on the Skin challenges the misconceptions and controversies surrounding self-harm. The book is crucial reading for professionals in the field as well as all those affected by this act.

‘A valuable contribution . . . Chaney insightfully highlights the gender biases that have pervaded the discourse from the start: the way self-harmers were caricatured in gendered terms as deceitful and devious; the habit among some researchers of excluding men or older women from sample groups (on grounds of being “atypical”) in order to reinforce the assumption that the typical cutter was a young woman; and the tendency of practitioners to overlook sexual abuse – marginalized under the euphemistic purview of “family troubles” if mentioned at all – as a possible causative factor when considering a patient’s motives for self-harming . . . Chaney’s emphasis on the importance of communities and mutual support groups is especially apposite in the wake of last year’s closures of a number of state-funded Crisis Recovery Unit centres across the UK, in the name of fiscal austerity. The human cost of this penny-pinching will be impossible to quantify; but we can say with some certainty that it will prove a false economy.’ — TLS

‘[Sarah Chaney] candidly acknowledges that the book’s subject is personal, and reasons that there can be no true objectivity in academic research in any case. It’s a puzzlingly defensive starting position because her historical survey manages a decent and dignified arm’s-length analysis . . . The skill of this book is that it understands self-harm so broadly, sweeping within its remit a range of other forms of injury, including bloodletting, castration and flagellation . . . She is a diligent and extensive researcher . . . The impressively amassed sources and the sensitivity behind it suggest that there is more to discover and understand in the history of self-harm.’ — Times Higher Education

‘It’s an exquisitely original take, and one evinced by Chaney with an attractive intensity and wavering levels of confidence. Discursive, meticulously politically correct and, at times, metallic in tone, she attacks the shifting borders of psychiatry and its baleful gender bias.’ — The Australia

‘There is a lot of careful detail here, balanced against a set of “bigger pictures” – trends in medicine, politics and culture, with particular attention to gender differences. I enjoyed the eclecticism and fast pace; it is worth noting also the careful scholarship and respectful tone . . . by assembling a set of competing definitions, Chaney shows that the field of self-harm is contested and therefore contestable, not least by those who (like the author) have experienced medical treatment that they found alienating, or cruel.’ — Social HIstory of Medicine

‘In Psyche on the Skin, Chaney traces the illuminating and disturbing history of self-mutilation and other forms of self-harm . . . This work offers a fascinating look at a set of topics often as taboo to talk about as the acts themselves. It is strongly recommended for professionals likely to encounter individuals who have engaged in such acts.’ — Choice

‘The book is deeply important, both for the dimensionality of its approach to self-harm and for the broader critique it offers of diagnosis and medicalization. Chaney sends a message I think more people in the field need to hear.’ — PsycCritique

‘Self-harm is a crucially important topic for understanding psychology and culture in general and, often, religion in particular. For that reason, Sarah Chaney’s Psyche on the Skin is a welcome contribution.’ — Anthropology Review

‘Psyche on the Skin is a historical analysis of the global psychological issue of self-harm. My concern when choosing this book to review was that it might end up being a self-indulgent account of the authors own experience of self-harm. This book however offers an interesting and detailed account of different kinds of self-harm throughout the ages, beginning with the religious practice of castration and historical practice of therapeutic blood-letting.’ — Nursing Times

‘Well-written, clearly organized, and entirely intriguing . . . Psyche on the Skin is a fascinating and impressive piece of social history and analysis. Equally illustrative and didactic, it is a compelling argument against a universal model of self harm. It is also a model for how to approach other categories that have been caught up in the maw of psychiatric reductionism, certainly eating disorders, but perhaps even mood disorders like depression. For those skeptical or concerned over present day ideas about mental health and illness, including practitioners, mental health service users, social historians and philosophers of psychiatry, this is a valuable contribution.’ — Metapsychology

‘The author demonstrates the dubious utility of trying to contain such a range of behaviours, with so many antecedents, within a single diagnostic construct. It reminded me of one of my most important tasks as a psychiatrist. To, without preconceptions, help the patient in front of me to construct a narrative, articulate their predicament and use this understanding to enable change. Which, the author tells us, is what she has achieved by writing this book and, in doing so, I think she has succeeded in helping the reader to reflect on his or her assumptions about self-harm.’ — British Journal of Psychiatry

‘Eloquent, awe-inspiring, and sassy. This book will captivate anyone curious about the body and pain.’ — Joanna Bourke, author of The Story of Pain: From Prayer to Painkillers

‘A remarkable account from the pen of a young and brilliant scholar of the history and meaning of self-harm. Insightful and immensely readable.’ — Sander L. Gilman, Professor of Psychiatry at Emory University and author of Making the Body Beautiful: A Cultural History of Aesthetic Surgery

‘A valuable contribution . . . Chaney insightfully highlights the gender biases that have pervaded the discourse from the start: the way self-harmers were caricatured in gendered terms as deceitful and devious; the habit among some researchers of excluding men or older women from sample groups (on grounds of being “atypical”) in order to reinforce the assumption that the typical cutter was a young woman; and the tendency of practitioners to overlook sexual abuse – marginalized under the euphemistic purview of “family troubles” if mentioned at all – as a possible causative factor when considering a patient’s motives for self-harming . . . Chaney’s emphasis on the importance of communities and mutual support groups is especially apposite in the wake of last year’s closures of a number of state-funded Crisis Recovery Unit centres across the UK, in the name of fiscal austerity. The human cost of this penny-pinching will be impossible to quantify; but we can say with some certainty that it will prove a false economy.’ — TLS

‘[Sarah Chaney] candidly acknowledges that the book’s subject is personal, and reasons that there can be no true objectivity in academic research in any case. It’s a puzzlingly defensive starting position because her historical survey manages a decent and dignified arm’s-length analysis . . . The skill of this book is that it understands self-harm so broadly, sweeping within its remit a range of other forms of injury, including bloodletting, castration and flagellation . . . She is a diligent and extensive researcher . . . The impressively amassed sources and the sensitivity behind it suggest that there is more to discover and understand in the history of self-harm.’ — Times Higher Education

‘It’s an exquisitely original take, and one evinced by Chaney with an attractive intensity and wavering levels of confidence. Discursive, meticulously politically correct and, at times, metallic in tone, she attacks the shifting borders of psychiatry and its baleful gender bias.’ — The Australia

‘There is a lot of careful detail here, balanced against a set of “bigger pictures” – trends in medicine, politics and culture, with particular attention to gender differences. I enjoyed the eclecticism and fast pace; it is worth noting also the careful scholarship and respectful tone . . . by assembling a set of competing definitions, Chaney shows that the field of self-harm is contested and therefore contestable, not least by those who (like the author) have experienced medical treatment that they found alienating, or cruel.’ — Social HIstory of Medicine

‘In Psyche on the Skin, Chaney traces the illuminating and disturbing history of self-mutilation and other forms of self-harm . . . This work offers a fascinating look at a set of topics often as taboo to talk about as the acts themselves. It is strongly recommended for professionals likely to encounter individuals who have engaged in such acts.’ — Choice

‘The book is deeply important, both for the dimensionality of its approach to self-harm and for the broader critique it offers of diagnosis and medicalization. Chaney sends a message I think more people in the field need to hear.’ — PsycCritique

‘Self-harm is a crucially important topic for understanding psychology and culture in general and, often, religion in particular. For that reason, Sarah Chaney’s Psyche on the Skin is a welcome contribution.’ — Anthropology Review

‘Psyche on the Skin is a historical analysis of the global psychological issue of self-harm. My concern when choosing this book to review was that it might end up being a self-indulgent account of the authors own experience of self-harm. This book however offers an interesting and detailed account of different kinds of self-harm throughout the ages, beginning with the religious practice of castration and historical practice of therapeutic blood-letting.’ — Nursing Times

‘Well-written, clearly organized, and entirely intriguing . . . Psyche on the Skin is a fascinating and impressive piece of social history and analysis. Equally illustrative and didactic, it is a compelling argument against a universal model of self harm. It is also a model for how to approach other categories that have been caught up in the maw of psychiatric reductionism, certainly eating disorders, but perhaps even mood disorders like depression. For those skeptical or concerned over present day ideas about mental health and illness, including practitioners, mental health service users, social historians and philosophers of psychiatry, this is a valuable contribution.’ — Metapsychology

‘The author demonstrates the dubious utility of trying to contain such a range of behaviours, with so many antecedents, within a single diagnostic construct. It reminded me of one of my most important tasks as a psychiatrist. To, without preconceptions, help the patient in front of me to construct a narrative, articulate their predicament and use this understanding to enable change. Which, the author tells us, is what she has achieved by writing this book and, in doing so, I think she has succeeded in helping the reader to reflect on his or her assumptions about self-harm.’ — British Journal of Psychiatry

‘Eloquent, awe-inspiring, and sassy. This book will captivate anyone curious about the body and pain.’ — Joanna Bourke, author of The Story of Pain: From Prayer to Painkillers

‘A remarkable account from the pen of a young and brilliant scholar of the history and meaning of self-harm. Insightful and immensely readable.’ — Sander L. Gilman, Professor of Psychiatry at Emory University and author of Making the Body Beautiful: A Cultural History of Aesthetic Surgery

Sarah Chaney is a Research Associate at UCL Health Humanities Centre, and Research Project Manager at Queen Mary Centre for the History of Emotions, University of London.

Introduction

1 The Pre-History of Self-Harm: From Ancient Castration to Medicinal Bloodletting2 Morbid Impulse and Moral Insanity: The Emergence of Self-mutilation in Late Nineteenth-century Psychiatry3 Sexual Self-Mutilation: Masturbation, Masculinity and Self-control in Late Victorian Britain4 Motiveless Malignerers: Multiple Personality, Attention-seeking and Hysteria around 19005 Focal Suicide: Hypersexuality, Masochism and the Death Instinct in Psychoanalysis6 Delicate Self-Cutting: Schizophrenia and the ‘Borderline’ in Post-war North America7 Trigger Happy: Culture, Contagion and Trauma in the Internet Age